Parkinson’s disease (PD) is called a movement disorder because of the tremors, slowing and stiffening movements it can cause, and these are the most obvious symptoms of the disease. But Parkinson’s affects many systems in the body. Its symptoms are different from person to person and usually develop slowly over time.
There is no single test or scan for Parkinson’s, but there are three telltale symptoms that help doctors make a diagnosis:
Bradykinesia plus either tremor or rigidity must be present for a PD diagnosis to be considered.
Another movement symptom, postural instability (trouble with balance and falls), is often mentioned, but it does not occur until later in the disease progression. In fact, problems with walking, balance and turning around early in the disease are likely a sign of an atypical parkinsonism.
Additional Movement Symptoms
- Cramping (dystonia): sustained or repetitive twisting or tightening of muscle.
- Drooling (sialorrhea): while not always viewed as a motor symptom, excessive saliva or drooling may result due to a decrease in normally automatic actions such as swallowing.
- Dyskinesia: involuntary, erratic writhing movements of the face, arms, legs or trunk.
- Festination: short, rapid steps taken during walking. May increase risk of falling and often seen in association with freezing.
- Freezing: gives the appearance of being stuck in place, especially when initiating a step, turning or navigating through doorways. Potentially serious problem as it may increase risk of falling.
- Masked face (hypomimia): results from the combination of bradykinesia and rigidity.
- Micrographia: small, untidy and cramped handwriting due to bradykinesia.
- Shuffling gait: accompanied by short steps and often a stooped posture.
- Soft speech (hypophonia): soft, sometimes hoarse, voice that can occur in PD.
What Causes Parkinson’s Movement Symptoms?
Dopamine is a chemical messenger (neurotransmitter) that is primarily responsible for controlling movement, emotional responses and the ability to feel pleasure and pain. In people with Parkinson’s, the cells that make dopamine are impaired. As Parkinson’s progresses, more dopamine-producing brain cells die. Your brain eventually reaches a point where it stops producing dopamine in any significant amount. This causes increasing problems with movement.
Page reviewed by Dr. Chauncey Spears, Movement Disorders Fellow at the University of Florida, a Parkinson’s Foundation Center of Excellence.